Remember those multiple-choice tests where we had to pick one right answer? From the day we join school we are taught that there is always one right answer to a problem.

Fortunately, life teaches us otherwise. Get married or not? One child or two? Job or business? Study or work? Each decision takes a different trajectory and has the potential to fail or succeed. Life offers so many solutions that to stop at the first right answer is criminal. It limits imagination and in doing so, it limits possibilities.

The story of Shaping Demand and Practices (SDP) is a chronicle of considered experimentation, of creativity and innovation, of heartaches and headaches, of hard decisions and learning from failures… a story of challenging status quo, of asking difficult questions, of setting difficult targets and most importantly, of not stopping at the first right answer.

While working on the project, I learned the most fundamental thing about creativity and innovation. Innovation is not the result of a great creative mind. It is a result of a great unsolvable problem or a seemingly impossible challenge. And, it almost always starts with a difficult question. A question that will, surely, not have one right answer. Here’s an example…

Our initial research showed that for change to occur, among a zillion other things, it is critical to improve the inter-personal skills of community health workers and to provide them with a job aid that they can use to negotiate for behaviour change at the household level.

So, here was our first difficult question:

Can we create a job aid for health workers that can accommodate standardised, credible information on nine behaviours, over 45 simple doable actions, over 100 normative and belief arguments, that can be carried by a health worker at all times, with all its content, and while doing so create excitement among the health workers and the final beneficiaries?

Mobile Kunji

For years, the answer to this question has been a flipchart. There it was! Our first right answer. Unfortunately, in this case we would have to do over 9 different flipcharts and would have to create a suitcase or carton for health workers to carry them.

Past experience across countries has shown that most health workers do not carry flipcharts for home visits, as they are bulky. We also knew that flipcharts are very weak tools as they require text for standardising information and most health workers have limited literacy and even more limited communication skills. Since the idea was a box full of flipcharts, we were forced to think out of the box.

At this point we were convinced that we needed a technology enabled audio-visual job aid that can help digitise and standardise large amounts of information and make a health worker’s job easier, rather than more difficult.

Just around the time we were pondering over this problem, SPICE Mobile launched a projector phone that could project content, stored on the phone’s memory, on any wall. When I saw the TV ad for this phone, my mind started to race.

This had to be the right answer. Imagine a health worker delivering audio-visual content to families right in their homes using a hand-held projection device. Brilliant! But then reality struck. Bihar has over 200,000 health workers. Who will procure that many handsets? Who will maintain them? Who will replace them if they fall under cow’s dung or get stolen?

We were back to the drawing board and quite desperate. Tensions were running high and ideas were running low. And then the magic of creativity happened. We changed our paradigm.

Our research showed that 84% health workers owned a mobile phone but their phones were old, tattered and all they could do with it was make or receive a phone call. Our solution had to fit into their paradigm. And so, finally, we got our best right answer – a deck of cards and a simple phone call – and from there was born Mobile Kunji – a job aid that has gained national and international attention, won multiple innovation awards, is used by over 44,000 health workers, who have delivered over two million minutes of life saving health content to hundreds of thousands of families.

While designing many of our innovations we were told, “this will never work”. We have always taken such advice very seriously. All our innovations are based on rigorous formative research, intensive user-testing and are subjected to industry standard monitoring and evaluation norms.

When we were designing Mobile Academy, a mobile phone based audio learning course for health workers designed to enhance their inter-personal communication skills, we wanted to make the service self-sustainable. The solution was to negotiate a 90% reduction in call charges with mobile operators and then have the health workers pay the call charges to take the course.

Experts told us that this would never work. They said, “health workers are over-worked, underpaid and quite demotivated and unlikely to pay for a skill enhancement course”. Was our right answer on sustainability, wrong?

This is one instance where we learnt the criticality of good research and tough decisions. Our research clearly reflected a willingness to pay among health workers and we stuck with our plans. Today nearly 18,000 health workers are using Mobile Academy, and have paid for and consumed over 2.5 million minutes of content. Over 55% of them have already completed the course and received a certificate from Government of Bihar.

Whether designing a new format of radio show like Khirki Mehendiwali, developing ideas for campaigns like Ek Teen Do or rethinking the role of men as in the case of Kilkari, innovation requires constant evaluation of possibilities.

It requires a shift from self-righteousness to self- doubt, from giving answers to asking the right questions, from conforming to norms to challenging status quo. Most importantly, it requires a freedom from the fear of failure. Hopefully, the next big innovation is right around the corner.